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Bringing Prevention to the Bringing Prevention to the Table: Table:
Enhancing Service Array Enhancing Service Array Capacity Capacity
through through State Child Welfare/ State Child Welfare/
CBCAP CollaborationsCBCAP Collaborations
The Service Array ProcessThe Service Array Process
April 28, 2008April 28, 2008
FRIENDS National Resource Center for CBCAPFRIENDS National Resource Center for CBCAPA Service of the Children’s BureauA Service of the Children’s Bureau
and the U.S. Department of Health and Human Servicesand the U.S. Department of Health and Human Services
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What is Prevention?What is Prevention?
Refers to: Refers to:
– the act of preventing or the act of preventing or impeding something from taking impeding something from taking placeplace
– can also refer to a hindrance; an can also refer to a hindrance; an obstacle. obstacle.
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What are Prevention What are Prevention Programs/Services?Programs/Services?
• Prevention services/programs are designed Prevention services/programs are designed to stop/impede something from occurring to stop/impede something from occurring or from reoccurring/getting worse.or from reoccurring/getting worse.
• Examples would be: Examples would be: – Specific diseases/illnesses such as AIDS, heart disease, Specific diseases/illnesses such as AIDS, heart disease,
or spread of a disease or illness such as malaria or spread of a disease or illness such as malaria – SuicideSuicide– Accidents, crimes or gang involvement Accidents, crimes or gang involvement – Mental Health and/or Substance Abuse issues Mental Health and/or Substance Abuse issues – Child Abuse or Neglect Child Abuse or Neglect
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What is PreventionWhat is Preventionof Child Abuse and of Child Abuse and
Neglect?Neglect?• For the child welfare system, prevention usual For the child welfare system, prevention usual
means prevention of means prevention of reoccurrence of abuse or reoccurrence of abuse or neglectneglect or or prevention of removalprevention of removal once a child once a child and family are involved with the child welfare and family are involved with the child welfare system. It can also means prevention of a child system. It can also means prevention of a child returning to care/being removed from their returning to care/being removed from their caregiver. caregiver.
• For programs such as the Community-Based For programs such as the Community-Based Child Abuse Prevention (CBCAP) funded Child Abuse Prevention (CBCAP) funded programs, prevention services are targeted programs, prevention services are targeted towards prevention of child abuse and neglect towards prevention of child abuse and neglect prior to it happening or prior to any prior to it happening or prior to any involvement with the child welfare system. involvement with the child welfare system.
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What Does This Mean?What Does This Mean?• There is much confusion about what prevention is.There is much confusion about what prevention is.• People use the same word but it has very different People use the same word but it has very different
meanings.meanings.• Prevention is not just about one issue.Prevention is not just about one issue.• There is often a significant separation of the front end There is often a significant separation of the front end
programs/services – focused on preventing child abuse and programs/services – focused on preventing child abuse and neglect, from the rest of the child welfare system - dealing neglect, from the rest of the child welfare system - dealing with children and families reported to the child welfare with children and families reported to the child welfare system.system.
• Often the divide/disconnect is created/related to funding Often the divide/disconnect is created/related to funding streams.streams.
• There is a need for greater clarity as to what is meant by There is a need for greater clarity as to what is meant by prevention and what the range/continuum of prevention prevention and what the range/continuum of prevention programs and services is that is needed for children to be programs and services is that is needed for children to be kept safe with their families and in their communities. kept safe with their families and in their communities.
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Service Array and Service Array and Prevention Prevention
What does this mean for building a service What does this mean for building a service array ?array ?
• To keep children safe in their own home and To keep children safe in their own home and communities, a full range or continuum of communities, a full range or continuum of prevention of child abuse and neglect prevention of child abuse and neglect programs/services are needed. The range would programs/services are needed. The range would need to include the following services/programs:need to include the following services/programs:– For the general population that would focus on For the general population that would focus on
preventing child abuse/neglect from taking place:preventing child abuse/neglect from taking place:• Outreach and public education services—highlighting the risk Outreach and public education services—highlighting the risk
factors, where to get support, reporting of potential factors, where to get support, reporting of potential abuse/neglect, etc.abuse/neglect, etc.
• Family support services—available for all children and Family support services—available for all children and families.families.
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Service Array and Service Array and Prevention Prevention cont’dcont’d
• To support children and families and to To support children and families and to reduce the risk:reduce the risk:– These would be targeted to build on protective These would be targeted to build on protective
factors and reduce risk factors for the parents as factors and reduce risk factors for the parents as well as the child and reduce the potential harm for well as the child and reduce the potential harm for the child.the child.
– To educate the public.To educate the public.• To help ameliorate the impact on the child To help ameliorate the impact on the child
and family if child abuse or neglect did occur.and family if child abuse or neglect did occur.• To support parents and children to prevent To support parents and children to prevent
the reoccurrence of abuse and/or neglect. the reoccurrence of abuse and/or neglect. • To support parents and children to prevent To support parents and children to prevent
the child from coming into care.the child from coming into care.
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Service Array and Service Array and Prevention Prevention cont’dcont’d
• Children and families who are or might be involved Children and families who are or might be involved with the child welfare system, states/local with the child welfare system, states/local communities have a wide variety of needs and communities have a wide variety of needs and therefore would require a wide variety of prevention therefore would require a wide variety of prevention types of services for the child/youth as well as the types of services for the child/youth as well as the parents and/or family members beyond those aimed at parents and/or family members beyond those aimed at the prevention of child abuse and neglect such as: the prevention of child abuse and neglect such as: – substance abuse prevention/intervention services substance abuse prevention/intervention services
and support.and support.– mental health prevention/intervention services and mental health prevention/intervention services and
supports.supports.– domestic violence prevention/intervention.domestic violence prevention/intervention.
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Why a Continuum of Why a Continuum of Prevention of Child Abuse Prevention of Child Abuse
and Neglect? and Neglect? • Services are needed for families to be successful in Services are needed for families to be successful in
their communities. Keep in mind that not all families their communities. Keep in mind that not all families that experience difficulties end up having contact with that experience difficulties end up having contact with the child welfare systemthe child welfare system
• Services are needed to have improved outcomes for Services are needed to have improved outcomes for children and families involved with the child welfare children and families involved with the child welfare system system
• In first round of CFSRs one of the most common In first round of CFSRs one of the most common services gaps identified was prevention services (this services gaps identified was prevention services (this included services needed to keep children safe in their included services needed to keep children safe in their own homes).own homes).
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Why a Continuum of Why a Continuum of Prevention of Child Abuse Prevention of Child Abuse
and Neglect? and Neglect? Cont’dCont’d• States are involved in a number of prevention States are involved in a number of prevention
activities but often they are not activities but often they are not coordinated/linked. coordinated/linked.
• Many of the prevention programs/services fall Many of the prevention programs/services fall under various federal programs or utilize under various federal programs or utilize local, state, and/or foundation funds. local, state, and/or foundation funds.
• Most professionals agree that a continuum Most professionals agree that a continuum would consist of three levels of child abuse would consist of three levels of child abuse and neglect prevention services: primary and neglect prevention services: primary prevention, secondary prevention, and tertiary prevention, secondary prevention, and tertiary prevention.prevention.
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Continuum of Prevention ofContinuum of Prevention ofChild Abuse and Neglect Child Abuse and Neglect
ServicesServicesPrimary or Primary or UniversalUniversal
Secondary or Secondary or Selected Selected
Tertiary or Tertiary or IndicatedIndicated
Primary prevention Primary prevention consists of activities consists of activities that are targeted that are targeted toward the community toward the community at large. These at large. These activities are meant to activities are meant to impact families prior impact families prior to any allegations of to any allegations of abuse and neglect. abuse and neglect.
Secondary prevention Secondary prevention includes activities includes activities targeted to vulnerable targeted to vulnerable families that have one families that have one or more risk factors, or more risk factors, including families with including families with substance abuse, teen substance abuse, teen parents, parents of parents, parents of special needs children, special needs children, single parents, and low single parents, and low income families. income families.
Tertiary prevention Tertiary prevention consists of activities consists of activities targeted to families targeted to families that have confirmed or that have confirmed or unconfirmed child unconfirmed child abuse and neglect abuse and neglect reports. These families reports. These families have already have already demonstrated the need demonstrated the need for intervention, either for intervention, either with or without court with or without court supervision. supervision.
These are families that These are families that qualify for services qualify for services under child welfare under child welfare programs. programs.
These are families These are families where there is an open where there is an open case.case.
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Examples – Primary Examples – Primary PreventionPrevention
• Public awareness campaigns for prevention of Public awareness campaigns for prevention of child abuse and neglect, such as shaken baby child abuse and neglect, such as shaken baby syndrome, child sex exploitation, when to report syndrome, child sex exploitation, when to report abuse/neglect.abuse/neglect.
• Public education and outreach activities.Public education and outreach activities.• Information and referral regarding community Information and referral regarding community
and social services available for families.and social services available for families.• Parent education classes that are open to anyone Parent education classes that are open to anyone
in the community.in the community.• Family support programs – family resource Family support programs – family resource
centers.centers.Note: States/communities often fund these services with additional Note: States/communities often fund these services with additional
funding beyond their CBCAP grant funds.funding beyond their CBCAP grant funds.
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Examples - Secondary Examples - Secondary Prevention Prevention
• Parenting Classes – parent education/skills classes Parenting Classes – parent education/skills classes targeted for high-risk parents.targeted for high-risk parents.
• *Domestic violence services.*Domestic violence services.• *Concrete services (clothing, food, utility payment, housing *Concrete services (clothing, food, utility payment, housing
assistance, job training, transportation).assistance, job training, transportation).• *Counseling (for adults and for children).*Counseling (for adults and for children).• Population-specific services, e.g., Population-specific services, e.g.,
– Parents (all, new, teens, etc.).Parents (all, new, teens, etc.).
– Parents/children with disabilities.Parents/children with disabilities.– Racial and ethnic minorities.Racial and ethnic minorities.– Members of underserved or underrepresented groups.Members of underserved or underrepresented groups.– Fathers.Fathers.* NOTE: States/communities often fund these services with additional * NOTE: States/communities often fund these services with additional
funding beyond their CBCAP grant funds such as PSSF funds.funding beyond their CBCAP grant funds such as PSSF funds.
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Examples - Secondary Examples - Secondary PreventionPrevention cont’dcont’d• Respite care/crisis care for parents of a child Respite care/crisis care for parents of a child
with a disability or for families at risk of with a disability or for families at risk of abuse and/or neglect, such as:abuse and/or neglect, such as:– Crisis Nurseries.Crisis Nurseries.– Homemaker.Homemaker.– Parent aide.Parent aide.
• Voluntary home visiting programs for :Voluntary home visiting programs for :– New parents.New parents.– Pregnant teens.Pregnant teens.
• Parenting program for new moms.Parenting program for new moms.• Parent mutual support/self-help.Parent mutual support/self-help.NOTE: States/communities often fund these services with NOTE: States/communities often fund these services with
additional funding beyond their CBCAP grant funds such as additional funding beyond their CBCAP grant funds such as PSSF.PSSF.
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Examples - Secondary Examples - Secondary PreventionPrevention cont’dcont’d
• Mentoring programs for high risk youth.Mentoring programs for high risk youth.• Family resource centers/family support Family resource centers/family support
services for at risk families.services for at risk families.• Home based early intervention services for Home based early intervention services for
at risk populations, including:at risk populations, including:– Support for parents with children with special Support for parents with children with special
needs.needs.– Services/supports for children with special Services/supports for children with special
needs.needs.• Evidence-based programs such as Nurse Evidence-based programs such as Nurse
Family Partnership Program, Healthy Family Partnership Program, Healthy Families.Families.
NOTE: States/communities often fund these services with additional funding beyond their NOTE: States/communities often fund these services with additional funding beyond their CBCAP grant funds such as PSSF.CBCAP grant funds such as PSSF.
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Examples – Tertiary Examples – Tertiary PreventionPrevention
• Treatment/intervention services for Treatment/intervention services for children that have been abused and/or children that have been abused and/or neglected.neglected.
• Intensive family intervention services Intensive family intervention services where abuse/ neglect has taken place.where abuse/ neglect has taken place.
• Family reunification services to prevent Family reunification services to prevent reoccurrence of abuse/neglect. reoccurrence of abuse/neglect.
• Parenting Classes – for parents where Parenting Classes – for parents where abuse/neglect has taken place.abuse/neglect has taken place.
• Supports for Foster Parents and Resource Supports for Foster Parents and Resource Providers caring for children who have Providers caring for children who have been abused and/or neglected.been abused and/or neglected.
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Development of Service Development of Service ArrayArray
with Continuum of with Continuum of Prevention Prevention
• The child welfare system itself would not be The child welfare system itself would not be responsible to pay for/create all these services but responsible to pay for/create all these services but would want to partner/ collaborate with the would want to partner/ collaborate with the appropriate state/community/systems appropriate state/community/systems representative(s)/to ensure they are available in representative(s)/to ensure they are available in sufficient quantity and locations to be able to access sufficient quantity and locations to be able to access them on behalf of the children and families they are them on behalf of the children and families they are involved with or refer to them.involved with or refer to them.
• A key resource for primary and some secondary A key resource for primary and some secondary prevention services is the Community-Based Child prevention services is the Community-Based Child Abuse Prevention (CBCAP) program (CAPTA Title II Abuse Prevention (CBCAP) program (CAPTA Title II funding). funding).
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CBCAP CONCEPTUAL FRAMEWORK (revised 10-19-06)
SHORT-TERM & LONG-TERM INPUTS ACTIVITIES OUTPUTS INTERMEDIATE OUTCOMES OUTCOMES
The purposes of the CBCAP program are: (1) to support community-based efforts to develop, operate, expand, and enhance, and where appropriate to network, initiatives aimed at the prevention of child abuse and neglect; (2) to support networks of coordinated resources and activities to better strengthen and support families to reduce the likelihood of child abuse and neglect; and (3) to foster understanding, appreciation, and knowledge of diverse populations in order to effectively prevent and treat child abuse and neglect.
Underlying conditions: All families have inherent strengths but they also experience circumstances that impact their ability to provide for children’s basic physical and socioemotional needs. These risk factors increase for families experiencing geographic or social isolation, economic challenges, limited education or employment, inexperience with positive parenting, or physical or mental health issues. Target Population: All families, especially those at risk for abuse or neglect. Resources: CAPTA, Title II Federal CBCAP funding, other Federal funds and State and local matching funds to support prevention efforts
DIRECT Provide support for parents
Promote the development of parenting skills Improve access to formal/in formal resources Support the needs of individuals with disabilities Commit to parent leadership and engagement
DIRECT Numbers served through the continuum of preventive, family centered, culturally competent services (i.e. family resource and support, parent education, mutual support, home visiting, respite care, information and referral) Number of parents involved with program planning and evaluation
Individual and Family/ Relationships Levels Increase in the number of
families’ needs assessed and connected to needed services within their own communities
Increase in protective factors to prevent abuse or neglect by parents and caregivers related to: bonding and attachment parental resilience knowledge of parenting and
child development social connections concrete support in times of
need Decrease in risk factors associated
with reasons for service. Community Level Increase in the availability of
appropriate evidence-based and evidence-informed programs
Increase in number of agencies developing and implementing action plans to address meaningful parent involvement
Increase in coordination across prevention, child welfare and other child and family service systems (i.e. substance abuse, mental health, education, early childhood, disability)
Increase and expansion of Statewide networks of family support and prevention programs
Increase in the use of a continuum of evaluation approaches implemented
Societal level Increase in private, State and
Federal funding for prevention and family support
Increase in public understanding and engagement for the prevention of child abuse and neglect
SAFETY Children are protected
from abuse and neglect. Children are maintained
in their own homes. Decrease in rate of first
time victims. Decrease in rate of first
time perpetrators. PERMANENCY Children have
permanency and stability in their living situation.
The continuity of family relationships and connections is preserved for children.
WELL-BEING Families have enhanced
capacity to provide for their children’s needs.
Children’s educational, physical and mental health needs are met.
Children have opportunities for healthy social and emotional development.
Youth make a successful, self-sufficient transition to adulthood.
Diversity of families is embraced and supported.
CONTINUOUS IMPROVEMENT Development of a culture of continuous improvement in the strengthening of families and the prevention of abuse and neglect.
INDIRECT Support networks of coordinated resources Maximize and leverage funding for prevention Conduct public awareness and education Advocate for systemic change Ongoing assessment and evaluation
INDIRECT A public-private network of prevention and family support programs Number of funding mechanisms that blend Federal, State, local and private funds Numbers reached through public awareness and education Number of advocacy activities Number of self-assessment, peer review, evaluation and quality assurance efforts
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CBCAP Program CBCAP Program • To support To support development and expansion development and expansion
of community-based and prevention-of community-based and prevention-focused programs and activitiesfocused programs and activities to to support and strengthen families and support and strengthen families and prevent child abuse and neglect.prevent child abuse and neglect.
• To support To support meaningful involvementmeaningful involvement of of all parentsall parents, including parents with , including parents with disabilities, in planning, implementing disabilities, in planning, implementing and evaluation of prevention programs.and evaluation of prevention programs.
• To enhance States’ To enhance States’ evaluation evaluation capabilitycapability to determine effectiveness of to determine effectiveness of funded prevention programs and funded prevention programs and activities. activities.
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CBCAP Program CBCAP Program continuedcontinued
• To promote To promote greater linkagesgreater linkages with other with other National and Statewide systems change efforts National and Statewide systems change efforts such as the Child and Family Services Reviews such as the Child and Family Services Reviews (CFSRs).(CFSRs).
• To support To support training and technical assistancetraining and technical assistance for lead agencies on program requirements, as for lead agencies on program requirements, as well as support ACF Priorities, e.g., healthy well as support ACF Priorities, e.g., healthy marriage, responsible fatherhood, outreach to marriage, responsible fatherhood, outreach to faith- and community-based programs, positive faith- and community-based programs, positive youth development, and the rural initiative. youth development, and the rural initiative.
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CBCAP Target CBCAP Target PopulationsPopulations
• Vulnerable familiesVulnerable families at risk of abuse or at risk of abuse or neglect.neglect.
• Special focus on sSpecial focus on specific populationspecific populations::– Parents (all, new, teens, etc.).Parents (all, new, teens, etc.).– Parents/children with disabilities.Parents/children with disabilities.– Racial and ethnic minorities.Racial and ethnic minorities.– Members of underserved or Members of underserved or
underrepresented groups.underrepresented groups.– Fathers. Fathers.
• Includes activities for Includes activities for General General Population.Population.
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Authorized Activities under Authorized Activities under CBCAPCBCAP
• Provide Provide comprehensive supports for parents.comprehensive supports for parents.
• Promote Promote development of parenting skillsdevelopment of parenting skills, , especially young parents or those with young especially young parents or those with young children.children.
• Improve family accessImprove family access to formal and informal to formal and informal resources.resources.
• Support needs of parents with disabilitiesSupport needs of parents with disabilities through respite or other activities.through respite or other activities.
• Provide referralsProvide referrals to early health and to early health and development services.development services.
• Promote Promote meaningful parent leadership.meaningful parent leadership.
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Other Authorized Other Authorized ActivitiesActivities
• Financing development of continuum of Financing development of continuum of prevention servicesprevention services through public –private through public –private partnerships.partnerships.
• Financing start-up, maintenance Financing start-up, maintenance expansion, or redesignexpansion, or redesign of Child Abuse of Child Abuse Prevention programs and activities that are Prevention programs and activities that are identified as unmet needs.identified as unmet needs.
• Maximizing fundingMaximizing funding through leveraging through leveraging funds for Child Abuse Prevention programs and funds for Child Abuse Prevention programs and activities.activities.
• Financing public education activitiesFinancing public education activities that that focus on health and positive development of focus on health and positive development of parents and children and promotion of Child parents and children and promotion of Child Abuse Prevention. Abuse Prevention.
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• Capacity to Capacity to direct interdisciplinary, direct interdisciplinary, collaborative structurecollaborative structure that guides that guides planning for program and activities.planning for program and activities.
• Provide Provide oversight for goals and oversight for goals and objectivesobjectives of program. of program.
• AssessAssess community needs and assetscommunity needs and assets through a process that involves public and through a process that involves public and private agencies.private agencies.
• Provide Provide training, technical assistance training, technical assistance and evaluation assistanceand evaluation assistance to funded to funded programs.programs.
Lead Agency Lead Agency RequirementsRequirements
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Lead Agency Lead Agency Requirements Requirements (cont’d)(cont’d)
• Evaluate funded programsEvaluate funded programs and activities. and activities.
• Actively Actively participate in CAP monthparticipate in CAP month activities.activities.
• Insure parent involvementInsure parent involvement in planning, in planning, implementing and evaluation of programs.implementing and evaluation of programs.
• Participate in actions to Participate in actions to advocate for advocate for system change.system change.
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Resources Resources • Website – Website – www.friendsnrc.orgwww.friendsnrc.org• CBCAP State Lead Agency (SLA) contact - CBCAP State Lead Agency (SLA) contact -
http://http://www.friendsnrc.org/contacts/contacts.aspwww.friendsnrc.org/contacts/contacts.asp
• FRIENDS NRC for CBCAP FRIENDS NRC for CBCAP – Director – Linda Baker – Director – Linda Baker – [email protected]@nc.rr.com– TA CoordinatorsTA Coordinators
• Alicia Luckie – Alicia Luckie – [email protected]@elmore.rr.com• Cassandra Furman - Cassandra Furman - [email protected]@wavecable.com• Edi Winkle - Edi Winkle - [email protected]@windstream.net
• Federal Project Officer Federal Project Officer – Melissa Brodowski - Melissa Brodowski -
[email protected]@acf.hhs.gov
